Abstract
PURPOSE OF REVIEW: The review summarizes the key new recommendations of the WHO 2013 guidelines for antiretroviral therapy and describes the potential impact of these recommendations on the HIV epidemic. RECENT FINDINGS: The 2013 WHO guidelines recommend earlier initiation of antiretroviral therapy (ART) at CD4 500 cells/μl or less for all adults and children above 5 years. Further recommendations include initiation of ART irrespective of CD4 cell count or clinical stage for people co-infected with active tuberculosis disease or hepatitis B virus with severe liver disease, pregnant women, people in serodiscordant partnerships, and children under 5 years of age. The ART regimen comprising a once daily fixed-dose combination of tenofovir + lamivudine (or emtricitabine) + efavirenz is recommended as the preferred first-line therapy. Several approaches are also recommended to reach more people and increase health service capacity, including community and self-testing, and task shifting, decentralization, and integration of ART care. SUMMARY: If fully implemented, the 2013 WHO ART guidelines could avert at least an additional 3 million deaths and prevent close to an additional 3.5 million new infections between 2012 and 2025 in low- and middle-income countries, compared with previous treatment guidelines.
Original language | English (US) |
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Pages (from-to) | 528-534 |
Number of pages | 7 |
Journal | Current opinion in HIV and AIDS |
Volume | 8 |
Issue number | 6 |
DOIs | |
State | Published - Nov 1 2013 |
Externally published | Yes |
Keywords
- Public health approach
- Simplification
- Strategic use
- antiretroviral therapy
ASJC Scopus subject areas
- Immunology
- Hematology
- Oncology
- Oncology(nursing)
- Infectious Diseases
- Virology